• Home
  • News
  • Circumcision not cure-all for public health, ACON warns
Circumcision not cure-all for public health, ACON warns
Mar08

Circumcision not cure-all for public health, ACON warns

LAST UPDATED // Wednesday, 07 March 2012 17:54

ACON has reiterated its position to not support the implementation of male circumcision as a HIV prevention strategy in Australia, after a call last week by a number of local experts for public hospitals to perform infant circumcisions.

The calls came on the back of a new study which found that the procedure reduces risk of urinary infections, cancer and other conditions such as HIV following a comprehensive assessment of international evidence and a risk-benefit analysis of circumcision.     

The study’s research leader, Brian Morris, a professor of Medicine at the University of Sydney, said the study shows that in uncircumcised infants, the risk of urinary tract infection and kidney inflammation is 10 times higher than for circumcised boys.

The study also suggests that in later life, the risk of HIV and syphilis is three to eight times higher, while the chances of developing prostate cancer and penile cancer are also increased for uncircumcised males.

“The evidence in favour of infant circumcision is now so strong that advocating this … procedure for baby boys is about as effective and safe as childhood vaccination,” Morris said.

“The scientific evidence shows no adverse effects on sexual function, sensitivity, satisfaction or sensation, if anything the opposite.

“It is now up to state governments to ensure that bans on elective infant male circumcision in public hospitals are lifted without delay. And it is essential that the federal government revises the Medicare rebate so that this procedure is … affordable.”

ACON CEO Nicolas Parkhill told SX that with over 80 per cent of newly acquired HIV notifications in Australia arising from homosexual activity, he did not view circumcision as an essential HIV prevention priority in the Australian context, particularly as the current evidence had only shown that circumcision would be effective in contexts where there is a high risk of contracting HIV through female to male transmission.

“ACON does not support the implementation of male circumcision as a HIV prevention strategy in Australia.

“It’s likely that there would be a modest sex between men prevention benefit  were all guys to be circumcised, but nowhere near at the level to justify a general reintroduction of the practice,” Parkhill said.

“A comprehensive health promotion approach including promoting consistent condom use is the safest and most cost effective HIV prevention strategy particularly with an epidemic which is concentrated amongst gay men and other men who have sex with men.”

Recent studies in the past decade involving heterosexual men in parts of Africa where there is a high prevalence of HIV infection have found that circumcision can offer significant population-level prevention benefits.

In 2007, the World Health Organisation and UNAIDS recommended that an expansion of male circumcision services be reserved for countries with “hyperendemic and generalized HIV epidemics and low prevalence of male circumcision”.

SHARE THIS ARTICLE

Comments (8)

  • Jo

    19 March 2012 at 10:58 |
    Brian Morris is no expert on circumcision, but merely an enthusiastic circumcision fanatic of long standing. He neither holds degrees (nor genuine interests) in surgery, urology, pediatrics, nor epidemiology, and his field of study is only remotely related to medicine. He is in no way an authority on circumcision, much less male genitalia, child care, nor disease prevention. Is there any reason why Australian news outlets don't bother to consult someone who is?

    reply

  • JackieNo

    10 March 2012 at 01:37 |
    Why would anyone consider the statement "no adverse effects on sexual function, sensitivity, satisfaction or sensation - if anything the opposite" from someone that is missing the parts in question? I have the parts and they include stretch and touch sensors. One touches or is touched at these parts, one stretches or one is stretched at these parts and the result is pleasure. Remove the parts, the result is removal of pleasure from ones life for good. We now also know with certainty that the loss of nerves, the loss of the natural dynamics, the loss of all of that penis tissue, all contribute to males having sexual dysfunction at a much younger age. This is harm and the STD data actually shows zero benefits.

    BTW, this no loss stuff is really silly given that human's have known for thousands of years that baby boy penis parts removal adversely affects sexual function and pleasure. For centuries it has been accepted that the removal of the foreskin reduces male sexual pleasure. Maimonides wrote “As regards circumcision, I think that one of its objects is to limit sexual intercourse, and to weaken the organ of generation as far as possible, and thus cause man to be moderate. ,,,Circumcision simply counteracts excessive lust; for there is no doubt that circumcision weakens the power of sexual excitement, and sometimes lessens the natural enjoyment”

    Dr. John Kellogg (of the US cereal fame) advocated circumcising young boys to check/curb masturbation -- to lower sexual pleasure.

    reply

  • Tom Tpbin

    09 March 2012 at 00:46 |
    This piece is the sanest treatment of circumcision I've seen in a long time.
    Serkan Ozturk is to be commended for clearheaded journalism.
    I agree that this piece needs greater exposure. That would be a service to men everywhere.
    I also agree that it's time to let the University of Sydney know that Morris is making them look like fools internationally. Morris recommends circumcision for bathroom splatter.

    reply

  • radical53

    08 March 2012 at 21:07 |
    We also need to remind these medical professionals (Brian Morris) etc that they are breaking the law in regards to our human rights.

    Please let's hand them a copy of The United Nations Universal Declaration of Human Rights.

    reply

  • Ladyfingers

    08 March 2012 at 20:51 |
    Brian Morris' particular brand of lunacy needs more exposure.

    http://www.drmomma.org/2009/11/brian-morris-his-circumfetish-push-to.html

    reply

  • radical53

    08 March 2012 at 20:39 |
    Andrew,

    Your article is so enlightening. Needs to be published nationally. So everyone can read it. Not just here on SX News.

    It is so true and this tiresome subject keeps rearing it's ugly head all the time.

    I have always said, if nature was meant that we were born circumcised, then we would have.been. Therefore it is a violation of our human rights.

    The law seem very inadequate when it comes to us men. One law for women and one for men. But we are not protected under the law as we should be.

    Us men must stand up and protect ourselves from other men (medical professionals) who think they know what is best and in our best interest.

    reply

  • Andrew

    08 March 2012 at 19:12 |
    Here is my two bob worth. A human rights piece from about 3 years ago i did. Avid defender of the person. Let the child decide. Not some headonistic surgeon who resents he had it done on himself.


    Male Genital Mutilation

    Male genital mutilation is a practice that dates back to ancient Judaic times (Szasz, 2007, p. 81). It has been a symbol of religion and health throughout the ages and has been both preached and persecuted. The controversial surgery is without doubt a massive impact upon a person’s life - but is the simple snip ethical and within universal human rights?

    Throughout most of the world, laws regarding male genital mutilation are part of a grey area between right and wrong (Morris, 1999, pp. 8 - 9). Does tradition and history justify the forced and permanent alteration of a body? And why to date are the human rights infringements which occur as a result of these surgeries overlooked? The answers to these questions run far deeper than everyday society’s reasons; the concepts and meanings around the modification are deeply rooted in tradition, medicine, culture, and naivety. It is necessary, then to explore why these human rights infringements are still occurring in societies around the world.

    One issue to be discussed is why female genital mutilation (FGM) is seen as an impediment of human rights but male circumcision is justified through culture, traditions and practices. The procedure of female genital mutilation removes a portion of the outer vaginal skin and leaves the exterior genitalia smooth with a single hole being visible for the allowing of intercourse and urination (Gilbert, Bayley, & Christine Royal Australian College of Obstetricians and Gynaecologists., 1997, p. 9). This surgery is banned or harshly monitored in most first world countries. Australia has gone to measures to eradicate FGM by signing such documents as The Universal Declaration of Human Rights (1984), The Convention on the Rights of Children(1990) and The Declaration on Violence Against Women (1993:includes specific reference to FGM) (Gilbert et al., 1997, p. 20). Understanding the importance Australia places on removing this violation against women but not men can help to illustrate how the monitoring of human rights are entirely contextual and often unjust.

    Many countries throughout the world have severe penalties for anyone involved in practicing any form of FGM i.e. Australia carrying a maximum of 7 years for any form of FGM performed (Gilbert et al., 1997, p. 21). This leads to questions around why performing essentially the same alteration to a penis is legal. A male circumcision involves the excise of the foreskin and frenulum of the penis (Darby, 2005, p. 5). This surgery permanently alters the state of the male genitalia and decreases the sensitivity and protection that the normal penis would provide (Darby, 2005, p. 23). This form of mutilation is parallel to FGM but is overlooked as an infringement of human rights.

    Various articles in the United Nations Universal Declaration of Human Rights state that people, both males and females, have the right to freedom and choice regardless of their age, location, class, religion and country of origin. It must be noted then, that circumcising a male infant is a direct violation of many articles within the Declaration. Key articles which are blatantly infringed are articles 3, 5, 6 and 7.

    Article 3 states that every person has the right to life, liberty and security of person. This article is breached when a male is circumcised. Their liberty and security are sacrificed for an alteration that is beyond their control. This infringement denies them their autonomy and breaches the declaration’s direction.

    Article 5 suggests that no one shall be subject to torture or to cruel, inhuman or degrading treatment or punishment. This is infringed in circumcising a young male child, seen by the fact that topical or no anaesthetics are implemented during the surgery (Massachusetts Medical Society, 1997). This form of torture can also extend to the fact the infants in most first world countries are strapped to a Circumstraint table whilst the procedure is occurring (Massachusetts Medical Society, 1997). When a child is forcefully held and has pain induced upon them then this article’s purpose is defeated.

    Article 6 states that every person has the right to recognition everywhere as a person before the law. When a child is circumcised by choice of their parents their right to be viewed as a person is abolished. The law ceases to view the child as a person and then views them as an extension of their parent’s ideas and values. This concept negates this article and supposedly justifies the procedure.

    Article 7 decrees that all persons are considered equal before the law and are entitled, without any discrimination, to equal protection from the law. This is infringed when a child is circumcised; bodily modification requires consent of the person (Browne, 2009). By not allowing the child who is being circumcised to consent to the surgery themselves, and allowing the parents to choose, this human right is infringed upon. It is also impeded because the United Nations Universal Declaration of Human Rights and the Convention on the Rights of the Child state that both males and females will be viewed as equal. If a surgery that is essentially the same on both sexes’ is only banned for females then the law does not perceive both sexes of equal importance.

    It is simple to note that these articles within the declaration are being infringed however what is the cause of this? Awareness and understanding of this controversial procedure is often stigmatised and cast aside due to a social and moral dismissal of the seriousness of the issue. It is suggested that it is against social standards to discuss the implications of male circumcision (Darby, 2005, p. 13). This concept can reach and reflect the importance that the police force places on the monitoring of male circumcision. Police are enlisted in countries to serve and protect the rights of people in society, their role is to treat all equally before the law and prevent any unlawful infringements upon individuals (Commonwealth Secretariat, 2006, p. 29). When police allow infringements on human rights in the form of male genital cutting to occur, then they could be seen as neglecting their duties. This concept is where the grey areas around male circumcision begin to arise.

    Male circumcision as a ritual procedure in Australia was made lawful in the case of R v Brown in which the judge allowed parents to consent to the circumcision assault being incurred upon their child (Boyle, Svoboda, Price, & Turner, 2000, p. 2). This case extended to common circumcision, bringing the topical procedure into a consensual dilemma debate. Most circumcisions are legal in Australia, as long as a circumcision can be proven for ritualistic or medical necessity. Policing authorities therefore have no power to forcefully stop the procedure (Boyle et al., 2000). This creates a problem; the infringement of human rights incurred in ritualistic and medical circumcisions has been made legal. It is then hard for Police in Australia to uphold their obligations in preventing this human rights infringement. The question is then raised, if police assisted in bringing about the eventual ban of female genital cutting because it was viewed as wrong, why are they not exceeding their duties to stop the human right infringement also placed on juvenile males?

    The laws and procedures which affect the human rights of a male circumcision vary from country to country. In Australia it is lawful to circumcise for ritual or medical purposes, this can be compared to Denmark which prevents all male circumcision from being performed unless medically necessary (A R Gatrad, A Sheikh, & H Jacks, 2002). Looking at the country and how it views circumcision develops the idea of how varying locations or cultures allow human rights infringements to occur. Legal attitudes towards the procedure generally reflect the society’s views. If a society is poorly educated then they will scarcely change their views which have been embedded by culture (Auvert et al., 2005). This explains why some African nations maintain high circumcision rates; the idea of male circumcision has been embedded into their culture over generations and therefore is not monitored by law, because society believes it is necessary (S Moses, RC Bailey, & Ronald, 1998). This example demonstrates why the human rights infringements that occur as a result of the procedure are allowed to happen in certain countries. Human rights promote a uniform equality and allowing this to be impeded because of what a society believes negates the very reason for their existence (Commonwealth Secretariat, 2006, p. 13). Protective services such as the police, regardless of the country, are supposed to monitor these infringements. However to this day, in some countries this is not the case. This develops how police work and human rights monitoring is entirely contextual and thus allows for the continual breach that occurs after a male circumcision is performed.

    Serious studies have been conducted around the physical, emotional and mental harm that occurs as a direct result of male circumcision. This data is not widely shown or accessed due to the lack of importance placed around the issue. Several studies refer to in-depth analyses of the short and long term mental and physical effects which result from male circumcisions. This research shows further how circumcision infringes the right of a child and why a male circumcision should be classified as a breaking of human rights.

    One study shows that a male circumcision induced so much pain that the infants neurological circuitry was irreversibly altered, permanently enhancing pain perception and pain response in the infant (Gregory J Boyle, Ronald Goldman, J. Steven Svoboda, & Ephrem Fernandez, 2002a). In some cases, this obstructed maternal bonding between the child and mother and increased sensitivity to infants pain threshold during vaccinations 6 months later (Boyle et al., 2002a). Other studies show a reduction in the child’s sexual desire in later life and the feelings of sexual deformity and retreat during social intimacy (Gregory J Boyle, Ronald Goldman, J Steven Svoboda, & Ephrem Fernandez, 2002b). Findings such as these are often ignored by culture and prior beliefs. In a modern society, beliefs that circumcision is a simple minor operation are easily disproven. It is then that these beliefs and rituals become questionable - why are they simply enough to allow human rights infringements to not be monitored or prevented by law and law enforcers?

    The awareness raised around the seriousness of female genital cutting is staggering compared to that of the male comparison. Simple exploration of literature around the topic provides staggering results about the seriousness of the prevention, awareness and education in eradicating female genital mutilation. It is then not similar for males whose same standards are perceived to be far less important in the awareness of the male genital mutilation. Global organisations have realised this and are considered frontline ‘intactivists’ around supporting equal human rights for males in regards to genital cutting (Morris, 1999, p. 8).

    Organisations such as the National Organisation to Halt the Abuse and Routine Mutilation of Males (NOHARM) and the National Organisation of Circumcision Information Research Centres (NOCIRC) are the leading foundations that fight to support the human rights of male infants in regards to circumcision. They supply the key information needed to provide parents with enough knowledge to make informed decisions about their children and they also fight to promote consent for the child. Eileen Wayne, M.D. worked in conjunction with these organisations to explicitly provide the information needed for parents to make informed consensual choices for their child’s medical circumcision. The document outlines all aspects of the surgery and makes clear the reasons to allow the child to make the choice for themselves(Wayne, 1998). The document also gives guidelines for people performing the surgeries in how to obtain explicit consent with all aspects of the medical circumcision explained to the parent (Wayne, 1998). Whilst this document promotes human rights in relation to rights of the child, it only applies to children faced with medical circumcisions. Unfortunately explanation and consent documents such as the one discussed are not generally implemented or promoted in religious or ritualistic circumcisions. This simple demonstration of the neglect of information supplied to a bulk of the infant male circumcisions shows how little prevention into these human rights infringements is occurring.

    Debate often rages around the comparisons between circumcised and uncircumcised boys. Arguments such as health benefits and appearance issues are often used to promote circumcision and the unquestionable nature of it. However these arguments do not justify the infringements the mutilation places upon the boys affected by it. In a study conducted to compare the health and appearance statuses of young intact and circumcised boys it was concluded that significant differentiation occurred between the two (Laumann, Masi, & Zuckerman, 1997). The publication is old however minimal studies into such areas are less frequently conducted or promoted. This further proves how human rights infringements can avoid being questioned due to the lack of promotion given to them. The article explains how circumcised and uncircumcised males experienced varied sexually transmitted diseases and had varied responses to body image (Laumann et al., 1997). The study showed, however that in the younger generations of men who were circumcised, their body confidence issues changed and lessened as education and the taboo placed on circumcision and its absolute vitality were raised and enlightened. The study showed that regardless of the status of a male’s penis as generations passed, the younger generations seemed to promote circumcision far less. In acknowledging this, the potential decrease in human rights infringements placed on young males becomes possible.

    The education being promoted around the issue of infant male circumcision is occurring far slower than its female partner however change is occurring as a result of shifting times. Circumcision rates are uniformly dropping across countries and cultures (Laumann et al., 1997) which brings some justice to the human rights infringement that is occurring. Policing of the issue is often difficult because of the varied laws and social beliefs that cloud the clarity of the issue. Whilst male circumcision is a direct violation of the Universal Declaration of Human Rights and the Convention on the Rights of the Child, the developments of reduction strategies are occurring. Police can only prevent what is governed by the law they follow; however in agreeing to enforce the human rights code they neglect some of their duties in allowing infant male circumcisions to occur.

    In comparison to female genital mutilation the human rights issue placed on young males being circumcised is extreme. The bias suggesting that one is more important than the other is severe and needs to be addressed to fully acknowledge the human rights of a male child who faces circumcision. In order to progress past the extreme level to which people ignore the rights of male children who are exposed to a circumcision, education and breaking of social taboos is vital. An awareness into the issues of circumcision and the education of generations both civilians and enforcers is the only way change will occur. Emphasis placed on self choice and consent of the young males is the only means by which the human rights infringements occurring as a result of male circumcision will cease.

    References

    A R Gatrad, A Sheikh, & H Jacks. (2002). Religious circumcision and the Human Rights Act. ADC, 7.

    Auvert, B., Taljaard, D., Lagarde, E., Sobngnwi-Tambekou, J., Sitta, R., & Puren, A. (2005). Randomized, Controlled Intervention Trial of Male Circumcision for Reduction of HIV Infection RisK: The ANRS 1265 Trial. 2, 11.

    Boyle, G. J., Goldman, R., Svoboda, J. S., & Fernandez, E. (2002a). Male Circumcision: Pain, Trama & Psychosexual Sequelae. Journal of Health Psychology, 7, 329.

    Boyle, G. J., Goldman, R., Svoboda, J. S., & Fernandez, E. (2002b). Male Circumcision: Pain, Trauma and Psychosexual Sequelae. J Health Psychol, 7(3), 329-343.

    Boyle, G. J., Svoboda, J. S., Price, C. P., & Turner, J. N. (2000). Circumcision of Healthy Boys: Criminal Assault? Journal of Law and Medicine, 7, 301-310.

    Browne, K. (2009). JST201 Criminal Law - Consent. Charles Sturt University

    Commonwealth Secretariat. (2006). Commonwealth Manual on Human Rights Training for Police. London: Commonwealth Secretariat.

    Darby, R. (2005). A surgical temptation : the demonization of the foreskin and the rise of circumcision in Britain. Chicago: University of Chicago Press.

    Gilbert, Bayley, E., & Christine Royal Australian College of Obstetricians and Gynaecologists. (1997). Female genital mutilation : information for Australian health professionals. East Melbourne: Royal Australian College of Obstetricians and Gynaecologists.

    Laumann, E., Masi, C., & Zuckerman, E. (1997). Circumcision in the United States: Prevalence, Prophylactic Effects and Sexual Practice. American Medical Association, 277(13), 1052-1057.

    Massachusetts Medical Society. (1997). Efficacy and safety of Lindocaine-Prilocaine cream for pain during circumcision. The New England Journal of Medicine, 336(17).

    Morris, B. J. (1999). In favour of circumcision. Sydney: UNSW Press.

    S Moses, RC Bailey, & Ronald, A. (1998). Male circumcision: assesment of health benefits & risks. Sex Transm Inf, 74, 368-373.

    Szasz, T. (2007). The medicalization of everyday life : selected essays (1st ed.). Syracuse, N.Y.: Syracuse University Press.

    Wayne, E. M. (1998). Informed Consent for a Medically Necessary Circumcision. Retrieved 18, August, 2009, from http://www.informedconsent.org/circumcision.html

    reply

Leave a comment

You are commenting as guest. Optional login below.